Predictive complication factors for ct-guided fine needle aspiration biopsy of pulmonary lesions

Abstract

OBJECTIVE:Distinct aspects can influence the complication rates of computed tomography‐guided percutaneous fine needle aspiration biopsy of lung lesions. The purpose of the current study is to determine the influence of radiological techniques and clinical characteristics in predicting complications from this procedure.SUBJECTS AND METHODS:A retrospective study was developed involving 340 patients who were submitted to a consecutive series of 362 computed tomography‐guided fine needle aspiration biopsies of lung lesions between July 1996 and June 2004, using 22‐gauge needles (CHIBA). Variables such as the radiological characteristics of the lesions, secondary pulmonary radiological findings, co‐morbidities, and aspects concerning the procedure were studied.RESULTS:The diameters of the lung lesions varied from 9 to 140 mm, with a mean of 51.5 ± 24.3 mm and median of 40 mm. The depth of the lesions varied from 10 mm to 130 mm, with a mean of 44 ± 20.9 mm, and median median of 52 mm. Complications occurred in 52 (14.4%) cases, pneumothorax being the most frequent, with 40 (11.1%) cases, followed by hemoptisis with 7 (1.9%) cases, and hematoma with 4 (1.1%) cases. Lesions that did not contact the pleura, with normal pulmonary tissue interposition between lesion and pleura, had higher complication rates, with 22 (22%) cases, than lesions that contact the pleura, with 6 (9%) cases, with a statistically significant difference (p = 0.03).CONCLUSIONS:CT‐guided percutaneous fine needle aspiration biopsy of lung lesions had a lower rate of complications in our study and presented more rates of complications on lesions that lack pleural contact.

Risks of Transthoracic Needle Biopsy

“…Based on data from 12 single-institution retrospective case series, 5–10, 12, 15, 16, 19, 20, 22 the median risk of hemorrhage is 12% (range 2–66%). Based on the analysis of discharge records from 15,865 biopsies in 4 states, Wiener et al found a substantially lower risk of hemorrhage of 1.0% (95% CI 0.9-1.2%).…”

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

“…Bronchoscopic techniques are favored for nodules located in proximity to a patent bronchus and in individuals who are at high risk for pneumothorax following factors for pneumothorax included age 60 to 69 years, tobacco use, and COPD. In other single-center studies, risk factors for pneumothorax included older age, 90 smaller lesion size, [91][92][93][94] deeper location, [90][91][92][93][94][95][96] the need to traverse fi ssures, 91 the presence of emphysema, 95,96 and the number of needle punctures. 97 Use of needle biopsy is probably most appropriate when there is discordance among the clinical probability of cancer, imaging test results, patient preferences, and risk of surgical complications, as described in recommendation 4.6.2.1.1 .…”

A comparative study of chemotherapy combined with intermittent microwave ablation and chemotherapy in the treatment of oligometastatic non-small cell lung cancer

“…731, P < 0.01). Previous have shown that microwave ablation has synergistic effects with systemic chemotherapy [13,14]. Possible reason may be that chemotherapy can kill G1-S tumor cells, while microwave can kill and inactivate tumor cells in different phases without distinction.…”